Survey

Comprehensive School Health Policies

The NYS Dept. of Health Comprehensive School Health Polices RFA requires that we complete an assessment of where ALL school districts in the catchment area are in completing and implementing their School Health Index. We have set up this online survey that you can complete in less than 5 minutes to accomplish this. Thank you for taking the time to complete it.

1. Please provide the following:

Please provide the following: Name:
Title:
School:
School District:
Email Address:
Phone Number:

2. Have you completed a School Health Index within the last two years?

Have you completed a School Health Index within the last two years? Yes

3. Please tell us where you are

	Fully implemented	Partially implemented	Not yet developed
Tobacco policies	*Please tell us where you are Tobacco policies Fully implemented	Tobacco policies Partially implemented	Tobacco policies Not yet developed
Nutrition policies	Nutrition policies Fully implemented	Nutrition policies Partially implemented	Nutrition policies Not yet developed
Compliance with physical education regulations	Compliance with physical education regulations Fully implemented	Compliance with physical education regulations Partially implemented	Compliance with physical education regulations Not yet developed

4. We have the percentages of free and reduced lunch students in your schools for 2008-09. If available, please provide us with the data for your school for the 2009-2010 school year.

We have the percentages of free and reduced lunch students in your schools for 2008-09. If available, please provide us with the data for your school for the 2009-2010 school year. % free lunch
% reduced lunch

5. Please tell us what current resources you have in your school to reduce or prevent tobacco use, improve physical activity and healthy eating. (such as Eat Well Play Hard, Tobacco Control, Healthy Heart, Obesity Prevention)

Please tell us what current resources you have in your school to reduce or prevent tobacco use, improve physical activity and healthy eating. (such as Eat Well Play Hard, Tobacco Control, Healthy Heart, Obesity Prevention)

6. Do you wish to participate in the Comprehensive School Policies Grant?

Do you wish to participate in the Comprehensive School Policies Grant? Yes	No	Please call me to discuss
Please provide the number we should use to contact you

7. If you would like to participate do you want us to email you the draft MOU(Memorandum of Understanding), due back to us by December 18th?

If you would like to participate do you want us to email you the draft MOU(Memorandum of Understanding), due back to us by December 18th? Yes

8. Do you want more information about the Creating Healthy Places to Live, Work and Play grant which is due February 3, 2010?

Do you want more information about the Creating Healthy Places to Live, Work and Play grant which is due February 3, 2010? Yes

No, thanks

Click here for more information on the Comprehensive School Health Policies for Tobacco, Physical Activity and Nutrition grant School Health Policies grant.***** Click here for more information on the Creating Healthy Places To Live, Work and Play grant opportunity Healthy Places grant. Thank you!